loaparker

That's alright, we have a doctor who starts every story with 'triage gave a patient a cat 4 with an irregular pulse, chest pain, etc.., etc...' then proceeds to tell us how she had to save them.

Cannulas are my favorite thing. I will knock you down, to do your cannula, if I hear the IV trolley wheels start rolling! I work in ED where I get plenty of opportunity, it never gets old! Here are my tips. #1 be confident. If you think, 'I always miss a vein' you will. -set up all of your equipment and have it readily available. - take your time in finding the right vein. I often look at both arms, all locations. Many people see something, try to stick it and on the next go find a beauty of a vein on the other arm. - follow the vein. You need a vein that is long enough for your cannula and does not fork into another vein in that distance. Do not despare if it is crooked- easy fix read on. -as you prep the location talk to your patient, explain what is to be done and how it will feel and for how long. You would not believe the number of people that believe that the needle stays in. Persist Plus is great for preventing bacteria for up to 2 days-- but it can often dull the appearance of the vein. Alcohol wipes, brushed up- in the direction of the shoulder, can make the vein appear more visible. Make sure you allow whatever you use to dry-- if it is still drying when you pierce the skin it will go into the vein and BURN! -here is the biggest tip ever...... stabilize the vein. Pull the skin tight over the vein. This is so important as it holds the vein still AND it hurts MUCH less than if you don't. You will find just by stabilizing alone, you will be more successful. Also crooked veins become straight under this technique. - when you get flash back only advance the needle a tiny bit further and then only advance the canula. Use the little bump on the top of the hub to advance with your finger. Be positive and practice, practice practice. You will end up loving them, but do not come work with me, ... I WILL knock you down if you dare push that trolley.

Funny to hear about your gifts and your complaints-- I work in Australia and we have never received anything, not even a pen!

Hello, Wish I could give you good news, but I can not. I am an American who got my RN in Australia. I applied to CGFNS the moment I graduated and have JUST made it through and received Athority To Test- brace yourself.... the process took 3 YEARS! Although on a happier note, my friend, from my same school just got the process completed and it only took her 9 months. CGFNS is a NIGHTMARE to work with. All they want is $$$ followed by more $$$$ and talking to them is like talking to Dr Seuss. My best advice to you is to apply to the Florida Nursing Board and begin working thorugh that way as well. Both the board that I was applying to and the one my friend was applying to (different states) admitted that they are also frustrated with working with CGFNS and once a certain amount of paperwork had gone through, they were happy to work the rest on their end with me and my school which was extremely quick in comparison. Good luck, don't give up, but do not just sit back and wait-- or you will be in LTC when the ATT comes through on it's own.

Not a problem for us.... we still mix EVERY drug we give. I understand your concern, but honestly, every now and then when we are flat out, it would be a time saver!

Know just how you feel, in fact I am a new grad too and made my first one last night, same as you. I caught it, wrote an incident report on myself, told team leader and handed it over in the morning. It was my last night of 4 straight. I can not think clearly at 0200 after 4 nights-- being a new grad in ICU is hard enough without having to struggle with an unwilling brain!! ... chin up, we will get through this!!

I work at a hospital where we all wear identification badges, mostly hanging off of lanyards (scary) and no other form of ID. I am a new grad and find this a huge issue. I watch my patients faces as doctors, dietitians, physio's, etc, file in and out of their rooms. Badges swinging in the wind-- hard to read, and minimal if any introduction from the patient. As I am new, and live in the middle of Australia, could you tell me... does the hospital you work in have mandatory name tags with professional designations (in addition to, or other than photo id cards on lanyards)? Would love to know if someone can point me in the right direction for evidence based info on this-- I must be searching in the wrong areas because I am finding very little on this. Thanks for your help!

Would love to hear some stories about how you nurses have seen something that 'was not quite right' and went about fixing it on your wards-- maybe with evidence based practice. I am a new nurse in ICU and coming from an engineering background this really interests me, but have not found many threads on it. Would love to hear your !

... belly buttons- Can't stand the thought of something/someone touching mine. I could toss just thinking about it. I always have to have an article of clothing over mine and I don't want to see anyone else's either. Of course my kids and husband try to get a finger in every now and then, not quick enough. Do not know why they insist on gambling with vomit. ....don't get me started on belly button rings...:sasq:

Usual routine at home, bed, walker and wheelchair. Prosthetic leg worn a few hours most days. She was originally admitted with #NOF (on the same side as the existing BKA). Had not experienced anything out of the ordinary as far as stump pain since being admitted/surgery and transfer to HDU. Admitted to us with chest pain-STEMI. She was rating the pain in her stump as an 8/10. Thanks for the thought provokers-- does any of that information greater assist you in brainstorming efforts? I really appreciate it, has me really wondering.... Found the article in NURSING 2007 Banishing Phantom Pain. It stated that researchers speculate that external electromagnetic impulses irritate nerve endings and trigger phantom pain. There is a source study that believes that a stump stocking would block the impulses. source: Journal of Pain and Symptom Management, October 2006. The study was management of phantom pain with a textile, electromagnetically acting stump liner.

More about the situation: Was wondering if it could be due to the proximity of the electrical monitoring for the duration. She did not start experiencing this pain until approximately 18 hours after being in HDU. I know she is exposed to electrical impulses at home but in HDU other factors such as how close the monitors are to her bed, the bed being metal..... Just throwing things out- any thoughts....

I am a new grad working in ICU- I had a cardiac patient being monitored that progressively began complaining of pain in her BKA (2006). I did some research and only found one article (without reference) that cardiac monitoring can result in pain of the stump nerves due to 'outside' electrical current. Is this common knowledge? Would really appreciate it if someone could fill me in! My clinical nurse educator had never heard of it.

Amen! I too have entered ICU straight out of school. All I do is work (which is really 8-10 hours of controlled panic) then come home and hit the books trying to better understand conditions that I did not have time to look up at work. Must admit, was happy to see your post. After last nights shift, I am having a hard time slowing my HR in anticipation of this mornings shift. .... your panic gives me comfort- I am with you-- Surely we will laugh about this one day...

I can't stop laughing.....!

G'day Scrubby- I have also been trained in Australia as an RN and am just in the process of taking the NCLEX. I want to stay in OZ, but just making sure all my bases are covered if I ever have to move back to the states (I am American). We basically fall in the middle. In all my digging I have found out that some hospitals/states may not recognize us as BSN's because our degree is BNurse-- there is a way around it (long way>>>). The University of Phoenix accepts our degree as a BSN enabling us to enroll (can do it distance learning) in the MSN program. Once you have the MSN, nobody asks if you have a BSN.